CHUNGMI JO DENTAL PC
NPI: 1043725849
· MCKINNEY, TX 75070
· General Practice Dentistry
· NPI assigned 12/04/2017
$860.67
Total Medicaid Paid
Provider Details
| Authorized Official | KIM, CHUNGMI (OWNER) |
| NPI Enumeration Date | 12/04/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
77 |
$860.67 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$346.20 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$191.10 |
| D0230 |
Intraoral - periapical each additional radiographic image |
25 |
13 |
$172.65 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
13 |
$150.72 |
| D0603 |
|
13 |
13 |
$0.00 |